SPOKANE SURGERY CENTER LTD PS NPI 1902864879

NPI Information

  • NPI: 1902864879
  • Provider Name: SPOKANE SURGERY CENTER LTD PS
  • Classification: Clinic/Center - 261QA1903X
  • Specialization: Ambulatory Surgical
  • Entity Type: Organization
  • CLIA Number: 50D2303505
  • Address: 12109 E BROADWAY AVE STE C
    SPOKANE VALLEY, WA
    ZIP 99206
  • Phone: (509) 928-1990

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NPI Details

SPOKANE SURGERY CENTER LTD PS is an ambulatory surgical clinic center in Spokane Valley, WA. SPOKANE SURGERY CENTER LTD PS NPI is 1902864879. The provider is registered as an organization entity type.

The provider's business location address is:

12109 E BROADWAY AVE STE C
SPOKANE VALLEY, WA
ZIP 99206-133
Phone: (509) 928-1990
Fax: (509) 928-2933

The provider's authorized official is Stewart Pugmire Brim .
The authorized official title is Owner President and has the following contact phone number (509) 928-1990.

The CLIA number assigned to this NPI record is 50D2303505 - ambulatory surgery center with a certificate type of Certificate of Waiver.

The following top HCPCS codes were publicly reported for this provider under the Medicare program for the year 2016. The reported codes are based on the top codes for each available Medicare specialty, excluding evaluation and management codes.

  • Injection of lower or sacral spine facet joint using imaging guidance, single level (HCPCS:64493)
  • Injection procedure for sacroiliac joint; provision of anesthetic, steroid and/or other therapeutic agent, with or without arthrography (HCPCS:G0260)
  • Destruction of lower or sacral spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64635)
  • Injection of anesthetic and/or steroid drug into sacral spine nerve root using imaging guidance, single level (HCPCS:64483)
  • Correction of toe joint deformity (HCPCS:28285)
  • Injection of substance into lower spine canal using imaging guidance (HCPCS:62323)
  • Injection of substance into middle or upper spine canal using imaging guidance (HCPCS:62321)
  • Injection of upper or middle spine facet joint using imaging guidance, single level (HCPCS:64490)
  • Destruction of upper or middle spinal facet joint nerves using imaging guidance, single facet joint (HCPCS:64633)

The enumeration date for this NPI number is 5/2/2006 and was last updated on 12/4/2024.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1261QA1903XClinic/CenterAmbulatory SurgicalYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
17087760MEDICAIDWASHINGTON
2490000540OTHERWASHINGTONRAILROAD MEDICARE
3117682OTHERWASHINGTONLABOR & INDUSTRY

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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